Reasons the DOJ May Decide to Intervene in a False Claims Act Case

Whistleblowers are encouraged to file False Claims Act cases to disclose fraud involving payments by the government. The whistleblower claims are called qui tam actions. The qui tam actions often involve Medicare and Medicaid fraud. They can involve the Department of Defense or any agency that makes payments in good fa...

Reasons the DOJ May Decide Not to Intervene in a False Claims Act Case

The US Department of Justice has three options when a whistleblower files a qui tam action: It can decide to intervene. Intervention means the DOJ will agree to prosecute the case against the defendants and seek recovery for false billings and for treble damages. It can decide not to intervene. Here, the whistl...

Stark Law versus the Anti-Kickback Statute

Violations of either Stark Law or the Anti-Kickback Statute are usually grounds for filing a claim under the False Claims Act. Whistleblowers who know of instances where a physician has made referrals based on having a financial interest in the entity which is receiving the referral or know of instances where a doctor ...

What is Stark Law and how does it relate to the False Claims Act?

Stark Law is a set of laws that regulate how and under what circumstances physicians can make referrals. The starting point is the doctors cannot refer a patient to any entity where the doctor (or an immediate family member) has a financial interest in the entity and the entity bills Medicare for any treatments or prod...

Exceptions to Stark Law Violations

While Stark Law violations usually lead to allegations a medical practice, hospital, or health entity also violated the False Claims Act; whistleblowers do need to understand that Stark Law does provide for a number of exceptions. These exceptions are meant to cover situations where a physician or health practice is ac...

Federal False Claims Act Video 

We’ve helped whistleblowers earn multiple millions of dollars over the past 30 years. Our whistleblower complaint was the first selected by John Boese for his treatise on Civil False Claims and Qui Tam Actions (now in its fourth edition). That complaint, based on healthcare fraud, resulted in a multi-million ...

Three Whistleblowers Awarded Payments Through the False Claim Act for Disclosing Medicare Fraud

WBOC reported on November 8, 2109, that one of the New York’s largest healthcare providers, Northwell Health, Inc. (which includes Lenox Hill Hospital) agreed to pay $12.3 million to settle claims it submitted false bills to Medicare. The settlement was based on a lawsuit brought by three whistleblowers. The claim...

IRS Whistleblower Claims

IRS Whistleblower Claims In addition to federal and state False Claim Act cases, there are other laws that also provide that whistleblowers should be paid a percentage of any recovery for disclosing fraud - for a variety of different agencies. One of the agencies that have its own whistleblower program is the Int...

A Pharmacy, an Equity Firm, and Two Executives of the Pharmacy – Agree to Settle False Claims Act Allegations for $21.36 Million

The US Department of Justice reported on September 18, 2019 that a compounding pharmacy, Diabetic Care Rx LLC (Patient Care America), a private equity firm (Riordan, Lewis & Haden, Inc.) and the CEO and former VP of Patient Care America agreed to settle the charges which were centered on an alleged kickback scheme ...

What is Involved in a Financial Whistleblower Claim

As we discuss in our video, we first work to determine what type of fraud does the whistleblower wish to reveal. In Fortune 500 companies, fraud often involves financial irregularities. David Connlly of Freeman and Mills discussed fraud in more detail. David is a forensic accountant – a lawyer and a CPA. Some of ...